Do you recommend weekly SQ immunoglobulin replacement for an asplenic patient who only responded to 4/23 pneumococcal serotypes after the Prevnar 20 vaccine?

Immunoglobulin replacement therapy is indicated for those with evidence humoral immune dysfunction. This is typically evaluated in a T cell independent fashion using a pneumovax as a challenge mechanism (or possibly Salmonella typhi vaccine which is also polysaccharide). Poor response to prevnar is ...

If the patient has recurrent/chronic infections (check her sinuses as well, to help rule out other forms of pneumonitis), and other diagnoses such as CF have been ruled out, then her diagnosis may be specific (polysaccharide) antibody deficiency and IgG augmentation might be necessary. Given her rel...

Yes!